Knight Kelly R, Shade Starley B, Purcell David W, Rose Carol Dawson, Metsch Lisa R, Latka Mary H, Latkin Carl A, Gómez Cynthia A
Center for AIDS Prevention Studies, Department of Medicine, University of California at San Francisco, San Francisco, CA 94110-1372, USA.
J Acquir Immune Defic Syndr. 2007 Nov 1;46 Suppl 2:S80-7. doi: 10.1097/QAI.0b013e3181576828.
Few research studies have examined the HIV transmission risk behaviors of HIV-positive injection drug users (IDUs) who are men who have sex with men and women (MSMW).
We compared unprotected vaginal or anal sex with an HIV-negative or unknown (UNK) status sexual partner of MSMW (n=118) with men who have sex exclusively with women (MSW; n=469) and men who have sex exclusively with men (MSM; n=90) using baseline information from the Intervention for Seropositive Injectors-Research and Evaluation (INSPIRE) study, a 4-city randomized controlled trial.
MSMW were twice as likely to report unprotected vaginal sex (P<0.001) and 3 times as likely to report unprotected anal sex with an HIV-negative/UNK status female partner (P<0.001) as MSW. MSMW did not differ in their report of unprotected insertive anal sex and were half as likely to report unprotected receptive anal sex with HIV-negative/UNK status men (P=0.02) as MSM. MSMW were 2 times as likely to report engaging in transactional sex (buying or selling sex in exchange for money, drugs, or housing) than MSM or MSW (81%, 43%, and 36%, respectively; P<0.001).
Further research is needed to understand the contexts of unprotected sex among HIV-positive injection drug-using MSMW. Prevention programs should target the unique prevention needs of this population, particularly their risk with female partners.
很少有研究调查过同时与男性和女性发生性行为的艾滋病毒阳性注射吸毒者（MSMW）的艾滋病毒传播风险行为。
我们利用来自“血清阳性注射者干预研究与评估”（INSPIRE）的基线信息，比较了MSMW（n = 118）与仅与女性发生性行为的男性（MSW；n = 469）以及仅与男性发生性行为的男性（MSM；n = 90）与艾滋病毒阴性或状况不明（UNK）的性伴侣进行无保护阴道或肛交的情况。INSPIRE研究是一项在4个城市开展的随机对照试验。
与MSW相比，MSMW报告无保护阴道性行为的可能性高出两倍（P < 0.001），与艾滋病毒阴性/状况不明的女性伴侣进行无保护肛交的可能性高出3倍（P < 0.001）。MSMW在报告无保护插入式肛交方面没有差异，与艾滋病毒阴性/状况不明的男性进行无保护接受式肛交的报告可能性是MSM的一半（P = 0.02）。MSMW报告从事交易性性行为（以金钱、毒品或住房换取性行为）的可能性是MSM或MSW的两倍（分别为81%、43%和36%；P < 0.001）。
需要进一步研究以了解艾滋病毒阳性注射吸毒的MSMW中无保护性行为的背景情况。预防项目应针对这一人群独特的预防需求，尤其是他们与女性伴侣的风险。
